POS0027 INDIVIDUAL ENTHESEAL POINTS HAVE DIFFERENTIAL FREQUENCY OF INVOLVEMENT AND IMPACT ON PATIENT REPORTED OUTCOMES IN PATIENTS WITH ACTIVE PSORIATIC ARTHRITIS: POOLED ANALYSIS OF TWO PHASE 3, RANDOMIZED, DOUBLE-BLIND, PLACEBO-CONTROLLED STUDIES
Authors: L. Coates, I. Mcinnes, S. Aydin, M. Kishimoto, P. J. Mease, M. Shawi, M. Zimmermann, E. Rampakakis, F. Lavie, D. Mcgonagle
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> In patients (pts) with mono/oligoarticular psoriatic arthritis (PsA), swelling or tenderness of specific joints can be associated with poorer pt-reported outcomes (PROs) and physician global assessment<sup>[1]</sup>. We hypothesize that location of affected entheseal points may also have differential impact on PROs or time to enthesitis resolution with guselkumab (GUS). <h3>Objectives</h3> (1) Describe the distribution of affected entheseal points in pts with active polyarticular PsA; (2) evaluate the impact of anatomical location of enthesitis and Leeds enthesitis index (LEI) score on pt-reported pain (PtP), pt global assessment (PtGA), and functional status; and (3) compare the time to resolution of each entheseal point following treatment with GUS. <h3>Methods</h3> This post-hoc analysis used pooled data from adults with active PsA, despite standard therapies, from the DISCOVER-1 and -2 studies who were randomized to GUS 100 mg every 4 weeks (Q4W) or at W0, W4, then Q8W. Only pts with baseline (BL) enthesitis were included (N=473). Proportions of pts with enthesitis were determined for each entheseal point assessed by LEI score. Longitudinal impact of LEI score and location of individual entheseal points on PtP, PtGA, and health assessment questionnaire disability index (HAQ-DI), upon adjusting for potential confounders (age, sex, body mass index, prior TNFi use, BL PsA duration, SJC, TJC), was assessed with mixed models for repeated measures through W52. Time to resolution of enthesitis at each anatomical location was assessed with Kaplan-Meier survival analysis. <h3>Results</h3> Approximately half (49.5%) of GUS-randomized pts with BL enthesitis had an LEI score of 1 or 2. The most commonly affected entheseal point was Achilles tendon insertion among both pts with BL enthesitis and pts with an LEI score of 1 or 2. Through W52, higher BL LEI score was associated with increased PtP, PtGA, and HAQ-DI scores (<b>Table 1</b>). Of the individual entheseal points assessed, enthesitis of Achilles tendon insertion had the greatest impact on all PROs and enthesitis of medial femoral condyle the least. Following GUS treatment, median time to enthesitis resolution was W8 for each of the three anatomical locations assessed by the LEI (<b>Figure 1</b>). <h3>Conclusion</h3> In this population of pts with active polyarticular PsA, Achilles tendon insertion was the most commonly affected entheseal point and more highly associated with worse PtP, PtGA, and functional status. GUS treatment was associated with rapid enthesitis resolution, including resolution of Achilles enthesitis. <h3>Reference</h3> [1]Ayan G. Int J Rheum Dis. 2020;23(8):1094-9. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> Laura Coates Speakers bureau: AbbVie, Amgen, Biogen, Celgene, Eli Lilly, Galapagos, Gilead, Janssen, Medac, Novartis, Pfizer, and UCB, Consultant of: AbbVie, Amgen, Boehringer Ingelheim, Bristol Myers Squibb, Celgene, Eli Lilly, Gilead, Galapagos, Janssen, Novartis, Pfizer, and UCB, Grant/research support from: AbbVie, Amgen, Celgene, Eli Lilly, Janssen, Novartis, Pfizer, and UCB, Iain McInnes Shareholder of: Causeway Therapeutics, Evelo Compugen, Consultant of: AbbVie, Amgen, Astra Zeneca, Bristol Myers Squibb, Eli Lilly, Cabaletta, Compugen, GSK, Gilead, Janssen, Novartis, Pfizer, Sanofi, Roche, and UCB, Grant/research support from: Amgen, Astra Zeneca, Bristol Myers Squibb, Eli Lilly, GSK, Janssen, Novartis, Roche, and UCB, Sibel Aydin Consultant of: AbbVie, Celgene, Eli Lilly, Novartis, Pfizer, and UCB, Grant/research support from: AbbVie, Celgene, Eli Lilly, Novartis, Pfizer, and UCB, Mitsumasa Kishimoto Speakers bureau: AbbVie, Amgen, Asahi-Kasei Pharma, Astellas, Ayumi Pharma, Bristol Myers Squibb, Chugai, Daiichi-Sankyo, Eisai, Eli Lilly, Gilead, Janssen, Kyowa Kirin, Novartis, Ono, Pfizer, Tanabe-Mitsubishi, and UCB, Consultant of: AbbVie, Amgen, Asahi-Kasei Pharma, Astellas, Ayumi Pharma, Bristol Myers Squibb, Chugai, Daiichi-Sankyo, Eisai, Eli Lilly, Gilead, Janssen, Kyowa Kirin, Novartis, Ono, Pfizer, Tanabe-Mitsubishi, and UCB., Philip J Mease Speakers bureau: AbbVie, Amgen, Eli Lilly, Janssen, Novartis, Pfizer, Sun Pharma, and UCB, Consultant of: AbbVie, Aclaris, Amgen, Boehringer Ingelheim, Bristol Myers Squibb, Eli Lilly, Galapagos, Gilead, GSK, Inmagene, Janssen, Novartis, Pfizer, Sun Pharma, and UCB, Grant/research support from: AbbVie, Amgen, Bristol Myers Squibb, Eli Lilly, Galapagos, Gilead, Janssen, Novartis, Pfizer, Sun Pharma, and UCB, May Shawi Shareholder of: Johnson &amp; Johnson, Employee of: Immunology Global Medical Affairs, Janssen Pharmaceutical Companies of Johnson &amp; Johnson, Miriam Zimmermann Shareholder of: Johnson &amp; Johnson, Employee of: Janssen Research &amp; Development, LLC, Emmanouil Rampakakis Consultant of: Janssen, Employee of: JSS Medical Research, Inc., Frederic Lavie Shareholder of: Johnson &amp; Johnson, Employee of: Immunology Global Medical Affairs, Janssen Pharmaceutical Companies of Johnson &amp; Johnson, Dennis McGonagle Consultant of: AbbVie, Amgen, Bristol Myers Squibb, Celgene, Eli Lilly, Gilead, Janssen, Novartis, Pfizer, and UCB, Grant/research support from: AbbVie, Amgen, Bristol Myers Squibb, Celgene, Eli Lilly, Gilead, Janssen, Novartis, Pfizer, and UCB.